Provider Demographics
NPI:1487898789
Name:NILAR THEIN DDS A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:NILAR THEIN DDS A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NILAR
Authorized Official - Middle Name:
Authorized Official - Last Name:THEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-996-4057
Mailing Address - Street 1:717 N PLACENTIA AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3289
Mailing Address - Country:US
Mailing Address - Phone:714-577-0105
Mailing Address - Fax:
Practice Address - Street 1:717 N PLACENTIA AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3289
Practice Address - Country:US
Practice Address - Phone:714-577-0105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD48037122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty